Outcomes After Elective Colorectal Surgery by 2 Surgeons Versus 1 Surgeon in a Low-Volume Hospital

Published on 2019-08-10T12:08:20Z (GMT) by
<div><p><i>Background.</i> Improved patient outcomes after colorectal surgery in high-volume hospitals are leading to centralization of colorectal surgery. However, it is desirable to strive for optimal quality of colorectal surgery in low-volume hospitals. This study aimed to assess the effect of the number of surgeons involved in the surgical procedure on patient outcomes in a low-volume hospital. <i>Methods.</i> All patients who underwent elective colorectal surgery with construction of a primary anastomosis between January 1, 2007, and December 31, 2015, were included in this retrospective cohort. The propensity score was used to adjust for confounding. <i>Results.</i> A total of 429 patients were included. One hundred forty-three patients (33.3%) were operated by 1 surgeon and 286 patients (66.7%) were operated by 2 surgeons. Patients operated by 2 surgeons were younger, more often male, and had a higher body mass index. A multivariate analysis with propensity scores revealed that surgery with 2 surgeons was associated with fewer reoperations (odds ratio [OR] = 0.4, 95% confidence interval [CI] = 0.2-0.9, <i>P</i> = .038). Colorectal anastomotic leakage (OR = 0.6, 95% CI = 0.2-1.3, <i>P</i> = .204) and mortality (OR = 0.8, 95% CI = 0.2-3.7, <i>P</i> = .807) were not associated with the number of surgeons involved in the surgical procedure. <i>Conclusion.</i> The present study shows that elective colorectal surgery in a low-volume hospital performed by 2 surgeons resulted in fewer reoperations. This might positively influence patient outcomes and might be related to increased surgical quality as compared with procedures performed by only 1 surgeon.</p></div>

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Sparreboom, Cloë Lean; Lambrichts, Daniël P. V.; Menon, Anand G.; Kleinrensink, Gert-Jan; Lingsma, Hester F.; Lange, Johan F. (2019): Outcomes After Elective Colorectal Surgery by 2 Surgeons Versus 1 Surgeon in a Low-Volume Hospital. SAGE Journals. Collection. https://doi.org/10.25384/SAGE.c.4614200.v1